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2021 ◽  
Author(s):  
Yi Luan ◽  
Rui Ding ◽  
Wenshen Gu ◽  
Xiaofan Zhang ◽  
Xinliang Chen ◽  
...  

Abstract Since the end of 2019, the COVID-19 epidemic has swept the world. With the widespread spread of the COVID-19 and the continuous emergence of mutated strains, the situation for the prevention and control of the COVID-19 epidemic remains severe. On May 21, 2021, Guangzhou City, Guangdong Province, notified the discovery of a new locally confirmed case. Guangzhou became the first city in mainland China to compete with the delta mutant strain. As a local hospital with strong nucleic acid detection capabilities, Sun Yat-sen University Sun Yat-sen Memorial Hospital took the lead in launching the construction and deployment of the Mobile Shelter Laboratories and large-scale screening work in Foshan and Zhanjiang, Guangdong Province. Through summarizing "practical" experience, observation and comparison data analysis, we use real data to verify a feasible solution for rapid expansion of detection capabilities in a short period of time. We hope that these experiences will have certain reference value for other countries or regions, especially the underdeveloped areas of medical and health care.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linde Steenvoorden ◽  
Erik Oeglaend Bjoernestad ◽  
Thor-Agne Kvesetmoen ◽  
Anne Kristine Gulsvik

Abstract Background Penicillin allergy prevalence is internationally reported to be around 10%. However, the majority of patients who report a penicillin allergy do not have a clinically significant hypersensitivity. Few patients undergo evaluation, which leads to overuse of broad-spectrum antibiotics. The objective of this study was to monitor prevalence and implement screening and testing of hospitalized patients. Methods All patients admitted to the medical department in a local hospital in Oslo, Norway, with a self-reported penicillin allergy were screened using an interview algorithm to categorize the reported allergy as high-risk or low-risk. Patients with a history of low-risk allergy underwent a direct graded oral amoxicillin challenge to verify absence of a true IgE-type allergy. Results 257 of 5529 inpatients (4.6%) reported a penicillin allergy. 191 (74%) of these patients underwent screening, of which 86 (45%) had an allergy categorized as low-risk. 54 (63%) of the low-risk patients consented to an oral test. 98% of these did not have an immediate reaction to the amoxicillin challenge, and their penicillin allergy label could thus be removed. 42% of the patients under treatment with antibiotics during inclusion could switch to treatment with penicillins immediately after testing, in line with the national recommendations for antibiotic use. Conclusions The prevalence of self-reported penicillin allergy was lower in this Norwegian population, than reported in other studies. Screening and testing of hospitalized patients with self-reported penicillin allergy is a feasible and easy measure to de-label a large proportion of patients, resulting in immediate clinical and environmental benefit. Our findings suggest that non-allergist physicians can safely undertake clinically impactful allergy evaluations.


Toxics ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 251
Author(s):  
Pascal Kintz ◽  
Laurie Gheddar ◽  
Camille Paradis ◽  
Mickael Chinellato ◽  
Alice Ameline ◽  
...  

A 43-year-old male, sport coach, presented him-self at the Emergency unit of a local hospital for epigastric pain, myalgia pain and severe headache. He claimed having used for some days a combination of GW1516 (cardarine), a peroxisome proliferator-activated receptor delta agonist (PPAR- δ) and MK2866 (ostarine), a selective androgen receptor modulator (SARM) to gain skeletal muscles. Cytolysis with marked increase of alanine aminotransferase or ALT (up to 922 UI/L) and aspartate aminotransferase or AST (up to 2558 UI/L) and massive rhabdomyolysis with elevated creatine phosphokinase or CPK (up to 86435 UI/L) were the main unusual biochemistry parameters. Using a specific liquid chromatography coupled to tandem mass spectrometry method, cardarine and ostarine tested positive in blood at 403 and 1 ng/mL, respectively. In urine, due to extensive metabolism, the parent GW1516 was not identified, while ostarine was at 88 ng/mL. Finally, both drugs were identified in hair (2 cm in length, brown in colour), at 146 and 1105 pg/mg for cardarine and ostarine, respectively. This clearly demonstrates repetitive abuse over the last 2 months. Asthenia was persistent for 2 weeks and 6 weeks after the admission, the subject fully recovered.


2021 ◽  
Vol 9 (09) ◽  
pp. 891-896
Author(s):  
Alok Dixit ◽  
◽  
R. Venkatesh ◽  
T.T. Pradeep ◽  
Pratibha Prabhakar ◽  
...  

Background: Tumors of the nervous system are the second most common childhood tumors after leukemia,constituting approximately 35% of all childhood malignancies and remain the leading cause of cancer related deaths in children. In India,in the absence of a comprehensive population based national cancer registry,we depend on local hospital based registries for assessing the incidence of pediatric brain tumor.Hence,more and more institutional data are required to assess the actual disease load in India. Objective: The main objective of the present study is to assess the epidemiological patterns of brain tumors in children presenting in CMCH. Materials and Methods: Data regarding age,gender,topography and histopathology of 22 pediatric patients (0-18years)with brain tumors operated inCMCH over a period of 5 years(January 2015 to December 2019)was collected retrospectively and analysed. The results obtained were compared with available Indiandata and western literature. Results: Of 22 cases, males(63.6%) outnumbered females. In the present study, the most common anatomical site for brain tumors was cerebellum(45.5%) followed by cerebral hemispheres(36.2%), ventricles(13.6%) and sellar region(4.5%). The present study showed that Infratentorial tumors were more common (54.5%) as compared to Supratentorial tumors (45.5%).Thepresent study revealed that astrocytoma(36.4%) is the most common brain tumor in childhood. other common tumors include medulloblastoma(27.2%), followed by ependymoma(13.6%), oligodendroglioma(9%),pineal gland tumor(4.5%),craniopharyngioma(4.5%) and meningeal tumor(4.5%). Conclusion: From the present series, we conclude that, the frequencies of major histologic types of brain tumors found in the study do not differ substantially from that found in other developed and developing countries. Medulloblastomas and astrocytomas, which form the major histologic types in pediatric patients need special attention.


2021 ◽  
Vol 15 (09) ◽  
pp. 1277-1280
Author(s):  
Milos Dusan Babic ◽  
Lazar Angelkov ◽  
Milosav Tomovic ◽  
Mihailo Jovicic ◽  
Darko Boljevic ◽  
...  

Introduction: The estimated infection rate after permanent endocardial lead implantation is between 1% and 2%. Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. In this case report, we present a patient with delayed diagnosis and treatment due to the COVID-19 outbreak. Case Report: An 88-year-old, pacemaker dependent woman with diagnosed pacemaker pocket infection was admitted to the University Cardiovascular institute. The patient had a prolonged follow-up time due to the COVID-19 outbreak. She missed her routine checkup and came to her local hospital when the generator had already protruded completely, to the point where she held it in her own hand. Transthoracic echocardiogram showed possible vegetations on the lead. Transesophageal echocardiography was not performed due to the COVID-19 pandemic. On the day after the admission the patient underwent transvenous removal of the pacemaker lead using a 9 French gauge rotational extraction sheathe (Cook Medical). The extracted lead was covered in a thin layer of vegetations. Further follow-ups showed good recovery with no complications. Conclusions: A case showing delayed treatment of pacemaker pocket infection, due to delayed follow-up time during the COVID-19 pandemic. This patient underwent successful transvenous removal of the infected pacemaker lead, along with adequate antibiotic therapy, which has proven to be the most effective method of treating cardiac device-related endocarditis.


2021 ◽  
Author(s):  
Melissa Yan Ting Lee ◽  
Pui Wah Kong ◽  
Thanaporn Tunprasert

Abstract AimsThere is an overall lack of affordable and accessible offloading modalities for diabetic foot ulceration. The Mandakini is a cheap offloading device made-up of gloves. This study aims to investigate its effectiveness in reducing plantar pressures compared to 7mm semi-compressed felt (SCF) and barefoot walking. Materials and methodsPlantar pressures of 30 healthy staff from a local hospital in Singapore were captured under three offloading conditions – the Mandakini, SCF and barefoot walking (control). Peak pressure (PP), pressure-time integral (PTI) and contact time (CT) at the 1st metatarsal and its surrounding regions were analysed. Participants rated their comfort levels in each condition on a visual analogue scale from 1 to 10.Results Statistically significant reductions in PP and PTI of 43 ± 12 kPa (14%) and 14 ± 4 kPa.s (16%) respectively were observed at the 1st metatarsal with the Mandakini compared to control (p=0.001, p=0.002). Reductions were however significantly lower than SCF which reduced PP and PTI by 83 ± 11 kPa (28%) and 28 ± 3 kPa.s (33%) respectively compared to control (p<0.001, p<0.001). No statistically significant difference in CT was observed with the Mandakini compared to control (p=0.499). Comfort levels were not significantly different between the Mandakini and SCF with means 5.7 ± 1.8 and 6.2 ± 2.1 respectively (p=0.257). Conclusion This study highlights the Mandakini’s potential in providing cost-effective offloading through pressure redistribution. Nonetheless, in barefoot conditions, SCF should remain the preferred modality. Future pressure studies on patients with diabetes will provide better representations of the Mandakini’s effectiveness on the target population.


Author(s):  
Tudor Morar ◽  
Radu Pirlog ◽  
Sonia Vlaicu ◽  
Vasile Bintintan ◽  
Doinita Crisan

Necrotizing myositis represents a rare, aggressive form of bacterial-induced soft tissue necrotizing infection. We present a fulminant case of a 44-year-old patient with a necrotizing soft tissue infection  and a history of rheumatoid arthritis transferred to our service, Cluj-Napoca Emergency County Hospital, from a local hospital where he had been admitted two days before with chills and light-headedness after an accidental minor blunt trauma in the right thigh region. After admission to our hospital and first assessment, broad spectrum antibiotherapy was started with Meropenem, Vancomycin and Metronidazole along with surgical debridement. The evolution was fulminant with rapid development of multiple organ dysfunction syndrome, therefore he was transferred to the intensive care unit, intubated, and started the volemic resuscitation and vasopressor therapy. The blood culture was positive for group A beta-hemolytic streptococcus (GAS) and high dose Penicillin G was added to the therapeutic scheme. Despite all efforts, the patient developed disseminated intravascular coagulation syndrome and died in the next hours. The clinical picture together with the findings from the autopsy were suggestive for a streptococcal toxic shock syndrome developed as a complication of GAS induced necrotizing myositis.


Author(s):  
Chon Sum Ong ◽  
Nur Amalina Binti Che Din ◽  
Celine Mien Er Fong ◽  
Amira Nabiha Binti Jamalludin

An accident with a tamping iron made Phineas Gage a historically famous brain-injury survivor. (1) Each year, approximately 1.6 million people sustain traumatic brain injury, leading to 52,000 deaths annually. (2) However, there is limited literature regarding traumatic brain penetration injury that could be found. A 42-year-old male with psychosis forcefully inserted a butter knife through nostril, traversed via sella turcica into posterior corpus callosum in a mental health facility. He was intubated in his local hospital and transferred over to a tertiary hospital for neurosurgical intervention. Radiological imaging showed impingement of knife against the posterior cerebral artery (PCA), multiple brain infarcts, intraventricular, and subarachnoid haemorrhage. The knife was removed after securing the PCA with the collaboration between neurosurgery and interventional radiology team. Sinus repair was immediately performed by the otorhinolaryngologists. External ventricular drain was inserted due to hydrocephalus secondary to brain haemorrhage. He eventually developed ventriculitis leading to sepsis and was treated with multiple antibiotics. The traumatic brain injury led to anterior hypopituitarism and diabetes insipidus which was treated using hormone therapy. He not only survived the fatal brain injury but also regained his Glasgow Coma Scale (GCS) score. This case demonstrates the potential of a multi-disciplinary and specialty approach to achieve outcomes a single specialty team could not. The outcome of a case which was deemed to be a non-survivable brain injury was made different due to the bold decision making, experience and innovative surgical strategy. Future research is needed to better understand and manage brain penetration injury.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S27


2021 ◽  
Author(s):  
Rong Wei ◽  
Zixin Zeng ◽  
Ningning Shen ◽  
Ziyue Wang ◽  
Honghong Shen ◽  
...  

Abstract Background Pancreatic cancer has been a threateningly lethal malignant tumor worldwide. Despite the promising survival improvement in other cancer types attributing to the fast development of molecular precise medicine, the current treatment situation of pancreatic cancer is still woefully challenging since its limited response to neither traditional radiotherapy and chemotherapy nor emerging immunotherapy. The study is to explore potential responsible genes during the development of pancreatic cancer, thus identifying promising gene indicators and probable drug targets. Methods Different bioinformatic analysis were used to interpret the genetic events in pancreatic cancer development. Firstly, based on multiple cDNA microarray profiles from Gene Expression Omnibus (GEO) database, the genes with differently mRNA expression in cancer comparing to normal pancreatic tissues were identified, followed by being grouped based on the difference level. Then, GO and KEGG were performed to separately interpret the multiple groups of genes, and further Kaplan-Meier survival and Cox Regression analysis assisted us to scale down the candidate genes and select the potential key genes. Further, the basic physicochemical properties, the association with immune cells infiltration, mutation or other types variations besides expression gap in pancreatic cancer comparing to normal tissues of the selected key genes were analyzed. Moreover, the aberrant changed expression of key genes was validated by immunohistochemistry (IHC) experiment using local hospital tissue microarray samples and the clinical significance was explored based on TCGA clinical data. Results Firstly, a total of 22491 genes were identified to express differently in cancer comparing to normal pancreatic tissues based on 5 cDNA expression profiles, and the difference of 487/22491 genes was over 8-fold, and 55/487 genes were shared in multi profiles. Moreover, after genes interpretation which showed the >8-fold genes were mainly related to extracellular matrix structural constituent regulation, Kaplan-Meier survival and Cox-regression analysis were performed continually, and the result indicated that of the 55 extracellular locating genes, GPRC5A and IMUP were the only two independent prognostic indicators of pancreatic cancer. Further, detailed information of IMUP and GPRC5A were analyzed including their physicochemical properties, their expression and variation ratio and their association with immune cells infiltration in cancer, as well as the probable signaling pathways of genes regulation on pancreatic cancer development. Lastly, local IHC experiment performed on PAAD tissue array which was produced with 64 local hospital patients samples confirmed that GPRC5A and IMUP were abnormally up-regulated in pancreatic cancer, which directly associated with worse patients both overall (OS) and recurrence free survival (RFS). Conclusions Using multiple bioinformatic analysis as well as local hospital samples validation, we revealed that GPRC5A and IMUP expression were abnormally up-regulated in pancreatic cancer which associated statistical significantly with patients survival, and the genes’ biological features and clinical significance were also explored. However, more detailed experiments and clinical trials are obligatory to support their further potential drug-target role in clinical medical treatment.


2021 ◽  
Vol 32 (1) ◽  
pp. 38-40
Author(s):  
M. K. Derzhavin ◽  
V. M. Osipovsky

Currently, the coverage of rheumatic diseases is given a large place in the periodical medical literature.


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